https://orcid.org/0000-0002-0090-6289
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A.A. Chan, J. Noguti, C.T. Yang, S.R. Feldman, R.B. Wallace, A.H. Shadyab, J.E. Manson, A.K. Aragaki, R.T. Chlebowski, D.J. Lee, Association between menopausal hormone therapy and incidence of psoriasis: a secondary analysis from the Women’s Health Initiative randomized clinical trials, British Journal of Dermatology, Volume 185, Issue 3, 1 September 2021, Pages 669–671, https://doi.org/10.1111/bjd.20410
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Funding sources: none.
Conflicts of interest: R.T.C. is a consultant for Novartis, AstraZeneca, Genentech, Merck, Immunomedics and Puma; and has received honoraria from Novartis and AstraZeneca. The other authors declare they have no conflicts of interest.
Dear Editor, Oestrogen level fluctuations have been linked to psoriasis;1 however, the association between menopausal hormone therapy and risk of psoriasis is largely unexplored. We analysed data from the Women’s Health Initiative (WHI) randomized controlled trials comparing conjugated equine oestrogens (CEE) vs. placebo, and CEE plus medroxyprogesterone acetate (MPA) vs. placebo to investigate the association between hormone therapy use and psoriasis.
The original WHI Hormone Therapy Trials randomized 27 347 postmenopausal women aged 50–79 years from 40 US clinical centres between 1993 and 1998. Detailed eligibility criteria and recruitment methods have been published by the WHI.2 Human subject review committees at all participating sites approved the WHI protocols, and participants provided written informed consent. Active treatment with CEE alone lasted on average 7·2 years (ended March 2004) and CEE plus MPA lasted on average 5·2 years (ended July 2002). Women with psoriasis prior to WHI enrolment were excluded, and prevalent cases within a 2‐year look‐back period were excluded. Our final analysis included 7577 women with prior hysterectomy from the oestrogen‐alone trial who were randomized to a daily regimen of 0·625 mg of CEE or placebo, and 11 734 women with an intact uterus from the oestrogen‐plus‐progestin trial who were randomized to a combination of CEE 0·625 mg and MPA 2·5 mg daily or placebo.
